positive GBS status,
gestational diabetes and obesity were excluded.
Not exact matches
One of the most common pregnancy complications,
gestational diabetes affects one in 10 expectant women —
and because it occurs more often among obese women, rates of GDM in the United States have been rising along with
obesity rates.
The USA has higher rates of HIV,
obesity, poor access to antenatal care,
gestational diabetes, drug addiction
and pre-eclampsia than many developed nations.
What it does increase, however, is your risk of miscarriage
and gestational diabetes if your BMI crosses the threshold toward
obesity.
«There is limited evidence based data on how best to mitigate adverse metabolic effects of
obesity on mothers (spontaneous miscarriage,
gestational diabetes, pre-eclampsia
and need for cesarean delivery)
and their offspring (congenital anomalies, neonatal adiposity
and risk for childhood
obesity) once a woman is pregnant.
These include screening for risk factors for hypertension (such as
obesity and diabetes)
and early treatment if
gestational hypertension is detected.
1) Fasting biochemical screen
and lipid profile 2) 2 - hour oral glucose tolerance test (GTT) in patients with risk factors (
obesity, family history, history of
gestational diabetes)
and may indicate impaired glucose tolerance (insulin resistance) in 15 - 30 % of women with PCOS.
Testing should be considered for all individuals who are overweight or obese (BMI 25 or greater) plus the additional risks: first degree relative with
diabetes mellitus or Polycystic Ovarian Disease, history of
gestational diabetes, thyroid disorder, HDL level < 35 mg / dl
and / or Triglyceride level > 250 mg / dl, hypertensive, sedentary, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) on previous testing, women who delivered macrosomic baby (e.g. weighing > 9 lbs),
and other clinical conditions such as acanthosis nigricans, severe
obesity, polycystic ovary syndrome, dyslipidemia.
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Obesity predisposes a dam to
gestational diabetes,
and may make it hard to spot when active labor begins.
Risk factors for type 2
diabetes include older age,
obesity, family history, having
diabetes while pregnant (
gestational diabetes), a sedentary lifestyle,
and race / ethnicity.
Risk factors for the development of type 2
diabetes include older age,
obesity, positive family history,
and history of
gestational diabetes.
The relative contribution of prepregnancy overweight
and obesity,
gestational weight gain,
and IADPSG - defined
gestational diabetes mellitus to fetal overgrowth
Regarding the child, the importance of the intrauterine
and early postnatal environments for metabolic programming
and modifications of the epigenome is increasingly recognised, 12 — 14 particularly for metabolic diseases such as
obesity and diabetes.15 Thus, GDM is related to macrosomia at birth (> 4 kg), to excess body fat
and (central)
obesity and to insulin secretion in infants
and children, the
obesity being in part mediated by maternal body mass index (BMI) or birth weight.16 — 23 Intrauterine exposure to GDM also doubles the risk for subsequent type 2
diabetes in offspring compared with offspring of mothers with a high genetic predisposition for type 2
diabetes, but with normal glucose tolerance during the index pregnancy.24 Maternal prepregnancy overweight
and excessive
gestational weight gain also predict high birth weight
and adiposity during infancy.12 25 This is highly relevant, as up to 60 % — 70 % of women with GDM are overweight or obese before pregnancy.26 Finally, maternal lifestyle behaviour such as a high fat diet or lack of physical activity during pregnancy can influence offspring adiposity independent of maternal
obesity.12 27
Introduction
Gestational diabetes mellitus (GDM) carries prenatal
and perinatal risk for the mother
and her offspring as well as longer - term risks for both the mother (
obesity,
diabetes, cardiovascular disease)
and her child (
obesity, type 2
diabetes).